drugs used in asthma and COPD- corticosteroid

Question 1

what are the 5 main corticosteroid drugs used to treat asthma and COPD?

Answer 1

• beclometasone
• budsonide
• ciclesonide
• fluticasone
• mometasone

Question 2

when are corticosteroids used to treat COPD?

Answer 2

when used in combination with a beta-2-agonist a LABA or LAMA.

Question 3

what are some of the prescribing issues with beclometasone?

Answer 3

the brands prescribed are not interchangeable and must be prescribed by brand. so should check what patient has used before.

Question 4

what are the brands that beclometasone is prescribed as in a meter dosed inhaler?

Answer 4

qvar and clenil

Question 5

what is the difference between qvar and clenil?

Answer 5

qvar has extra fine particles compared to clenil, therfore more potent

Question 6

what situations may occur for the use of oral treatment of corticosteroids?

Answer 6

• as short term rescue therapy to bring symptoms under control
• asthma exacerbation

Question 7

where are corticosteroids used for asthma?

Answer 7

maybe used initially controlled and monitored during diagnosis and assessment then throughout treatment diagnosed adult asthma patient

Question 8

where are corticosteroids used for COPD?

Answer 8

throughout treatment but always in combination with LAMA or LABA

Question 9

how do corticosteroids act in the body?

Answer 9

• corticosteriod passes plasma membrane and enters cell
• binds to gluccorticoid receptor
• ligand binding allows homodiamirisation to occur leading to transolcation to nucleus and bind to homorne response elements
• proteins are either brought to the complex or not
• transcription to occur or not to occur
• for COPD look at how inflammation is reduced

Question 10

what are the effects of corticosteroids ?

Answer 10

-reduce number of dentritic cells and mast cells

Question 11

what are the effects of corticosteroids on the epithelial cells?

Answer 11

-reduction of cytokines
-reduction in chemokines= attract other cells allow pro-inflammatory effect
-reduction in enyzmes
-reduction in peptides
reduction in adhesion molecules

Question 12

what are some effects of asthma?

Answer 12

• cytokine its suppressing is IL-2 which prevents Th cells clonal expansion and prevents formation of cytokines Th2 cytokines which promote eosinophils that are responsible for promoting IgE production.
• inhibits vasosdilators PGe2 by inhibiting induction of COX-2